Baby Friendly hospitals in Scotland have increased their breastfeeding rate at 7 days by 8.1% over an eight year period, compared with a rise of just 2.2% among hospitals without a Baby Friendly award. Units with a Certificate of Commitment added 6.1% over the same period.

An analysis of breastfeeding information collected on the Guthrie cards of 131,759 babies born in1990-91 and of 118,055 born in 1997-98 found that the level of participation by hospitals in the UNICEF UK Baby Friendly Initiative was associated with a significant increase in breastfeeding rates. The study's authors conclude that all maternity units should be encouraged to engage fully in the initiative. (1)

The study supports the findings of a survey of 22 Baby Friendly hospitals across the UK which found an increase in the breastfeeding initiation rate of more than 10% over 4 years. On average, 70.6% of babies born in Baby Friendly hospitals were breastfed at birth during the year after they were accredited as Baby Friendly, an increase from 60% in these units four years earlier. (2)

Meanwhile, a cluster randomised controlled trial in the former Soviet republic of Belarus has found that implementing the Baby Friendly Hospital Initiative significantly increased the duration and exclusivity of breastfeeding and decreased the risk of gastrointestinal tract infection and of atopic eczema in the first year of life. (3)

The maternity hospitals of Belarus were randomly assigned to implement the Ten Steps or to a control group which continued the existing practices and policies. 16,491 mother-infant pairs were followed-up over 12 months. Babies born in the hospitals which had adopted the Baby Friendly Initiative principles were significantly more likely to be exclusively breastfed at 3 months (43.3% vs 6.4%; p<0.001) and at 6 months (7.9% vs 0.6%; p=0.01) and to be receiving any breastmilk at 12 months. They had a significantly reduced risk of gastrointestinal tract infection (adjusted odds ratio 0.60; 95% CI 0.40-0.91) and of atopic eczema (adjusted OR 0.54; 95% CI 0.31-0.95). No significant reduction in respiratory tract infection was found.